HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Antonio F. Corno Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Corno, A. F. Articles by von Segesser, L. K. Search for Related Content PubMed PubMed Citation Articles by Corno, A. F. Articles by von Segesser, L. K. Related Collections Congenital - cyanotic Related Articles

J Thorac Cardiovasc Surg 2002;124:105-112
© 2002 The American Association for Thoracic Surgery

Surgery for Congenital Heart Disease (CHD)

Chronic hypoxia: A model for cyanotic congenital heart defects

From the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland,^a and University of Milan, Milan, Italy.^b

Received for publication May 22, 2001. Revisions requested Aug 14, 2001; revisions received Sept 7, 2001. Accepted for publication Oct 22, 2001. Address for reprints: Antonio F. Corno, MD, FRCS, FECTS, Centre Hospitalier Universitaire Vaudois, 46 rue du Bugnon, CH 1011, Lausanne, Switzerland (E-mail: Antonio.Corno{at}chuv.hospvd.ch).

Objective: The postoperative course of cyanotic children is generally more complicated than that of acyanotic children. A possible reason is reoxygenation injury at the beginning of cardiopulmonary bypass. In this study we tested the hypothesis that reoxygenation of chronically hypoxic hearts is worse than that of normoxic hearts.
Methods: Two groups of rats (n = 9 each) were exposed to either room air (fraction of inspired oxygen, 0.21%) or chronic hypoxia (fraction of inspired oxygen, 0.10%) for 2 weeks. Hearts were then isolated and perfused for 30 minutes with hypoxic buffer (oxygen saturation, 10%), followed by 30 minutes of reoxygenation (oxygen saturation, 100%).
Results: In hypoxic rats hematocrit values, hemoglobin concentrations, and red cells were higher (69% ± 6% vs 40% ± 6%, 219 ± 14 vs 124 ± 12 g/L, and 10.30 ± 0.6 vs 6.32 ± 0.5/µL/1000, respectively; P < .0001); the amount of ingested food was less (22.3 ± 4.8 vs 30.7 ± 3.9 g/d, P < .001), as was the amount of ingested water (21.0 ± 3.1 vs 50.4 ± 14.6 mL/d, P < .0001); and body weight was lower (182 ± 14.2 vs 351 ± 40.1 g, P < .0001), as was heart weight (1107 ± 119 vs 1312 ± 128 mg, P < .005). The heart weight/body weight ratio was higher (6.10 ± 0.8 vs 3.74 ± 0.1 mg/g, P < .0001). Systolic and diastolic functions, not different during the hypoxic baseline period, were more impaired in hypoxic than in normoxic hearts after the reoxygenation, whereas coronary resistance remained lower. During the hypoxic perfusion, the venous partial pressure of oxygen remained low in both groups, whereas during reoxygenation, partial pressure of oxygen was higher in hypoxic hearts, with a lower (P < .01) oxygen uptake. During hypoxic baseline adenosine triphosphate turnover, lactate production and lactate turnover were lower in hypoxic hearts (P < .005, P < .0001, and P < .0001, respectively).
Conclusions: Body and blood values are severely affected by chronic hypoxia, and the cardiac effects of uncontrolled reoxygenation after chronic hypoxia are more severe than after acute hypoxia.

Related Articles

How do you study blue?

Charles B. Huddleston
J. Thorac. Cardiovasc. Surg. 2002 124: 14-15. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				A. Caretti, P. Bianciardi, R. Ronchi, M. Fantacci, M. Guazzi, and M. Samaja Phosphodiesterase-5 Inhibition Abolishes Neuron Apoptosis Induced by Chronic Hypoxia Independently of Hypoxia-Inducible Factor-1{alpha} Signaling Exp Biol Med, October 1, 2008; 233(10): 1222 - 1230. [Abstract] [Full Text] [PDF]

				A. R. Khan, M. Birbach, M. S. Cohen, R. F. Ittenbach, T. L. Spray, R. J. Levy, and J. W. Gaynor Chronic Hypoxemia Increases Ventricular Brain Natriuretic Peptide Precursors in Neonatal Swine Ann. Thorac. Surg., February 1, 2008; 85(2): 618 - 623. [Abstract] [Full Text] [PDF]

				A. F. Corno Systemic venous drainage: can we help Newton? Eur. J. Cardiothorac. Surg., June 1, 2007; 31(6): 1044 - 1051. [Abstract] [Full Text] [PDF]

				E. J. Hickey, X. You, V. Kaimaktchiev, and R. M. Ungerleider Hypoxemic reperfusion exacerbates the neurological injury sustained during neonatal deep hypothermic circulatory arrest: a model of cyanotic surgical repair Eur. J. Cardiothorac. Surg., May 1, 2007; 31(5): 906 - 914. [Abstract] [Full Text] [PDF]

				M. Fantacci, P. Bianciardi, A. Caretti, T. R. Coleman, A. Cerami, M. Brines, and M. Samaja Carbamylated erythropoietin ameliorates the metabolic stress induced in vivo by severe chronic hypoxia PNAS, November 14, 2006; 103(46): 17531 - 17536. [Abstract] [Full Text] [PDF]

				A. M. Draaisma, M. G. Hazekamp, N. Anes, P. H. Schoof, C. E. Hack, A. Sturk, and R. A.E. Dion Phosphorylcholine Coating of Bypass Systems Used for Young Infants Does Not Attenuate the Inflammatory Response Ann. Thorac. Surg., April 1, 2006; 81(4): 1455 - 1459. [Abstract] [Full Text] [PDF]

				M. L Schmitz, S. C Faulkner, C. E Johnson, J. L Tucker, M. Imamura, S B. Greenberg, and J. J Drummond-Webb Cardiopulmonary bypass for adults with congenital heart disease: pitfalls for perfusionists Perfusion, January 1, 2006; 21(1): 45 - 63. [Abstract] [PDF]

				D. A. Piel, A. R. Khan, R. Waibel, M. Birbach, M. S. Cohen, T. L. Spray, C. S. Deutschman, J. W. Gaynor, and R. J. Levy Chronic hypoxemia increases myocardial cytochrome oxidase J. Thorac. Cardiovasc. Surg., October 1, 2005; 130(4): 1101 - 1106. [Abstract] [Full Text] [PDF]

				G. Milano, P. Bianciardi, A. F. Corno, E. Raddatz, S. Morel, L. K. von Segesser, and M. Samaja Myocardial Impairment in Chronic Hypoxia Is Abolished by Short Aeration Episodes: Involvement of K+ATP Channels Exp Biol Med, December 1, 2004; 229(11): 1196 - 1205. [Abstract] [Full Text] [PDF]

				A. F. Corno, Y. Boone, I. Mallabiabarrena, M. Augstburger, P. Tozzi, E. Ferrari, and L. K. von Segesser Myocardial and pulmonary effects of aqueous oxygen with acute hypoxia Ann. Thorac. Surg., September 1, 2004; 78(3): 956 - 960. [Abstract] [Full Text] [PDF]

				A. F. Corno, Y. Boone, I. Mallabiabarrena, M. Augstburger, and L. K. von Segesser Aqueous oxygen: the solution to relief hypoxic pulmonary hypertension Eur. J. Cardiothorac. Surg., August 1, 2004; 26(2): 301 - 305. [Abstract] [Full Text] [PDF]

				A. F. Corno, G. Milano, S. Morel, P. Tozzi, C. Y. Genton, M. Samaja, and L. K. von Segesser Hypoxia: Unique myocardial morphology? J. Thorac. Cardiovasc. Surg., May 1, 2004; 127(5): 1301 - 1308. [Abstract] [Full Text] [PDF]

				H. Raff, J. J. Lee, E. P. Widmaier, M. K. Oaks, and W. C. Engeland Basal and Adrenocorticotropin-Stimulated Corticosterone in the Neonatal Rat Exposed to Hypoxia from Birth: Modulation by Chemical Sympathectomy Endocrinology, January 1, 2004; 145(1): 79 - 86. [Abstract] [Full Text] [PDF]

				C. B. Huddleston How do you study blue? J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 14 - 15. [Full Text] [PDF]

				B. S. Allen The reoxygenation injury: Is it clinically important? J. Thorac. Cardiovasc. Surg., July 1, 2002; 124(1): 16 - 19. [Full Text] [PDF]